Vitamin D: Levels, Dosing and Benefits of a Level over 50 ng/ml
Let’s explain why it’s important and what it should be. Calculate your Vitamin D dose, or get blood drawn. Studies show a level above 30 ng/ml cuts Covid mortality; many like it above 75.
If you explained to your doctor why you’d like it checked and then ask her to order a vitamin D blood test for you, will she? And what should it be, anyway?
Hmm… Without looking, I wonder if your doctor even knows what is normal …. 20? 30? 50? How about 75 ng/ml?
Let’s explain why it’s important and what it should be.
Low Vitamin D3 Levels. If your vitamin D is low, you’re more likely to die from COVID-19. Studies show a level above 30 ng/ml may "significantly decrease mortality" and a level above 50 ng/ml "may prevent any excess mortality" from COVID. Furthermore, Borsche et al, who published these findings in Nutrients, October 2021, state a COVID-19 mortality risk close to zero could theoretically be achieved at 50 ng/ml vitamin D3.
They agree vaccination is important to fight SARS-CoV-2, but encourage it should not be the only focus; the immune system should be strengthened.
Vaccination and COVID Cases. Brown et al showed in the MMWR Morbidity and Mortality Weekly Report of August 6, 2021, show that vaccinated people can still be infected with a breakthrough infection, particularly when associated with large public gatherings. Everyone is at risk of getting COVID, even those who have had it once; if you’re going to get COVID, improve survival by having a vitamin D level over 50.
A Solution. Patients with a vitamin D lebel over 50 ng/ml are not expected to die of COVID.
And even without a blood draw, there is a recommended range of vitamin D that is a “guess-timate”. based on your body habitus - small or large for height.
Vitamin D Deficiency
First described in the 19th Century when child laborers of the Industrial Revolution working in dark warehouses got soft bones, it is unfortunate that many current recommendations still define vitamin D deficiency at this outdated and lowest mark of 20 ng/dl (all units are in ng/dl). This was a low level established over 100 years ago for rickets.
Who is ever at 20 these days? Twenty is such a tragically low number that no one should have a level near it! Is a level of 30 or 35 much better?
Think. Think, because your very life may depend on it. If your doctor says your vitamin D level came back at “35”, is that okay with you?
Well that’s not a fair question, because you can’t see your blood test result. Ok, check below for your very own lab blood result that is in front of you during your appointment (we do this with all our patients).
Look all the way to the right, for the normal value seen at 30-100. The lab tells you that The Endocrine Society recommendation defines “deficiency” as less than 20, and “insufficiency” as between 21 and 29. So are you okay at 35 (you can reread the first paragraphs for a hint)?
Restated: Do you think it is sufficient for you to have a vitamin D level of 35? … when you can be at 50 or 70 with little down-side? To change your mortality? Shouldn’t it be over 50? The Rebel Patient in me is screaming ~ of course not!
Goal Vitamin D Level: Over 50. Many believe it should be 70-80.
Recommendation: Get your vitamin D level checked, to know what your "number" is, then replace with high-dose vitamin D. Or if no test is available, still replace with high-dose vitamin D using a table based on body mass index (BMI).. But why is vitamin D so important?
Top 3 Benefits of Vitamin D
1. Wide Impact on the Body. Vitamin D influences over 2500 genes, impacting dozens of serious conditions including modulating the innate and adaptive immune systems (B cells, T cells, natural killer or NK cells dendritic cells). It improves weakened or unregulated immunity and can improve diseases like virus infections, respiratory infections like ARDS, and several autoimmune diseases like multiple sclerosis. Vitamin D has been implicated in other disorders, such as autoimmunity and cancer.
2. Not Just a Vitamin: A Necessary Metabolism Hormone. Activated vitamin D3 receptor binding engages a conglomeration that forms a "vitamin D3 response element" (VDRE). Therefore, "vitamin" D is not just a vitamin; just like steroid hormones like cortisol or testosterone, it is a highly necessary hormone of equal importance to human metabolism. Some call it the “great hormone”.
3. COVID Severity and Recovery. COVID fatality rates tend to be worse in several patient populations who also have very low vitamin D3 levels: the elderly, African Americans, and those with co-morbidities like diabetes, obesity, heart disease, chronic inflammatory disease and cancer. So if you have one or more of those, you should definitely ask your doctor if your vitamin D level should be checked.
Next Steps
Know your blood vitamin D level. Ask your doctor if you should get it tested. Ask the doctor what value he thinks is “good” for you to have as a goal. What number? 20? 50? 75? If your level is low, can you be prescribed something like 50,000 IU/week? Because there’s no sense in ordering blood if you won’t get a prescription. If your doctor isn’t comfortable with this conversation, get another doctor. If your doctor doesn’t know enough to manage it, find another doctor who will, or one who can work with your doctor.
Because every doctor should be willing to learn how to fix an insufficient level (and no doctor is expected to know everything), we are happy to work with primary care doctors and even have a course for medical professionals; just email us at RenewAndRefresh@Substack.com.
There are two ways to determine how much vitamin D to take: with or without a blood level of vitamin D.
1. With a Blood Level
Simply find your blood level, look at the chart, and get your dose.
To get a blood level on your own (and without your doctor’s permission or involvement), simply pay cash at LIFE EXTENSION.com
2. Without A Blood Level
Most patients do not know their latest vitamin D level in the last 6 months. Many have not ever had a vitamin D test. Use this table as a temporary measure, then make arrangements to get your vitamin D level tested.
I am 5’4”. 5 feet x 12 inches/foot = 60 inches + 4 = 64 inches tall.
I choose 64 from the left column, then glide to the right until I reach about 120 lb, and I see 122 lb. I then follow that up to the top, which is a BMI of 21.
Then I look at the lower ranges to determine my dose. For a BMI of 20-29, I take 35,000 to 50,000 IU a week. That is to help with a presumed deficiency that everyone has from not being in the sun, and the sun being blocked by windows and sunglasses. I keep taking that as 5,000 IU a day or 10,000 IU five days a week.
If you use this chart or if you are low on vitamin D based on your blood level being below 100 ng/ml, be sure to re-check your blood level until it is above 100.
Measures Everyone Can Do
Increase morning time in the sun. This is not likely in the winter, or for many who work. But if you can, sit outside with your cup of coffee in the morning, especially between 10 am and noon, when it is the strongest. Be sure to take off your glasses and look around at God’s great earth.
Eat vitamin-D rich foods. Includes fortified milk and cereal; fish like cod, salmon, and tuna; beef and chicken, and mushrooms, especially Portabellas. If you already eat a bajillion mushrooms a day and your level is 30, perhaps your gut is not absorbing vitamin D, and a prescription may definitely be in order. Because who knows? You may need a transdermal method of delivery, through the skin. In this case, we bypass the gut.
Ask your doctor. To achieve a blood level vitamin D over 50 ng/ml, you may need a prescription of a high-dose vitamin D capsule at 50,000 IU, once or twice per week (most capsules only have 1000-5000 IU; you need 10-50 times more). Which gets us back to #1... know your blood vitamin D level.
Everyone deserves high-dose vitamin D and the best way to dose it is by knowing the patient’s blood level.
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References
1. Review. Immunologic Effects of Vitamin D on Human Health and Disease. Charoenngam N, Holick MFNutrients. 2020 Jul 15; 12(7). [PubMed] [Ref list]
2. Review. Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis. de Haan K, Groeneveld AB, de Geus HR, Egal M, Struijs ACrit Care. 2014 Dec 5; 18(6):660. [PubMed] [Ref list]
3. Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill. Braun A, Chang D, Mahadevappa K, Gibbons FK, Liu Y, Giovannucci E, Christopher KBCrit Care Med. 2011 Apr; 39(4):671-7. [PubMed] [Ref list]
4. Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Janssens W, Jensen ME, Kerley CP, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Trilok Kumar G, Urashima M, Camargo CA, Griffiths CJ, Hooper RLHealth Technol Assess. 2019 Jan; 23(2):1-44. [PubMed] [Ref list]
5. Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Janssens W, Jensen ME, Kerley CP, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Trilok Kumar G, Urashima M, Camargo CA, Griffiths CJ, Hooper RLHealth Technol Assess. 2019 Jan; 23(2):1-44. [PubMed] [Ref list]
6. Review. Regulation of Immune Function by Vitamin D and Its Use in Diseases of Immunity. Vanherwegen AS, Gysemans C, Mathieu C. Endocrinol Metab Clin North Am. 2017 Dec; 46(4):1061-1094. [PubMed] [Ref list]
7. Review. Modulation of the immune response to respiratory viruses by vitamin D. Greiller CL, Martineau ARNutrients. 2015 May 29; 7(6):4240-70. [PubMed] [Ref list]
8. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML.PLoS One. 2010 Jun 14; 5(6):e11088. [PubMed] [Ref list]
9. Association of vitamin D deficiency with severity of acute respiratory infection: A case-control study in New Zealand children. Ingham T.R., Jones B., Camargo C.A., Kirman J., Dowell A.C., Crane J. Eur Respir. J. Eur. Respir. Soc. 2014;44:124. [Google Scholar] [Ref list]
10. Review. The role of vitamin D in prevention and treatment of infection. Gunville CF, Mourani PM, Ginde AA. Inflamm Allergy Drug Targets. 2013 Aug; 12(4):239-45. [PubMed] [Ref list]
11. Review. Translating the role of vitamin D3 in infectious diseases.Khoo AL, Chai L, Koenen H, Joosten I, Netea M, van der Ven A. Crit Rev Microbiol. 2012 May; 38(2):122-35.
12. Review. The Relationship Between Vitamin D and Infections Including COVID-19: Any Hopes? Taha R, Abureesh S, Alghamdi S, Hassan RY, Cheikh MM, Bagabir RA, Almoallim H, Abdulkhaliq A. Int J Gen Med. 2021; 14():3849-3870. [PubMed] [Ref list]
13. Review Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Griffiths CJ, Janssens W, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S Jr, Stelmach I, Kumar GT, Urashima M, Camargo CA Jr. BMJ. 2017 Feb 15; 356():i6583. [PubMed] [Ref list]
I don't think that the government really wants you to know what a good vitamin D level is that will prevent not only Covid, but other things. Dr. Mercola and others have extensive articles about how vitamin D prevents cancer.
I find it fascinating and quite a shame that almost no doctors were preaching vitamin D supplements during the pandemic - and that the medical board in every Steve did not set up a hotline to teach doctors how to maximize vitamin D levels in a shorter period of time.
It takes about two weeks to increase your vitamin D level, so the time to start supplementing isn't the day that you get sick. If you don't already have a set of great vitamins to take daily, please take about doing it because you're almost 3 years too late now. Please do yourself a large favor and get on some supplements they provide you with vitamin D, vitamin C, zinc, quercetin, and melatonin.
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I just ordered my auto subscription of Metagenics Vit D and was surprised at the affordability for the high dose form! Im excited to add this to my arsenal to fight cancer, among other things. Thank you for educating me and making it so easy to place an order. Free shipping also!
Do you think cereal should be on the list of foods?